- Humana (Annapolis, MD)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Elevance Health (Hanover, MD)
- …abuse cases preferred. **Preferred Skills, Capabilities and Experiences:** + Experience in behavioral health utilization management is highly ... Behavioral Health Care Manager I- ... Behavioral Health Care Manager I- Behavioral ...there is licensed staff supervision. Previous experience in case management / utilization management with a broad… more
- Evolent (Annapolis, MD)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
- Highmark Health (Annapolis, MD)
- …coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Elevance Health (Hanover, MD)
- …medical benefits, including medical management . **Hours: 8am-5pm (Local time)** The ** Behavioral Health Care Manager I** is responsible for managing adult ... ** Behavioral Health Care Manager I -...** Behavioral Health Care Manager I - Ameriben** **Location** :...Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad… more
- Johns Hopkins University (Baltimore, MD)
- …enrollment and appointments for specialty substance use services and behavioral health care. + Manage tracking and utilization of resources. + Register ... Medicine is seeking a full time **_Substance Use & Behavioral Health Linkage_** . Under the direct...organized and detail oriented. + Excellent organizational and time management skills. + Independent and self-motivated. + Ability to… more
- Highmark Health (Annapolis, MD)
- …This role supports the full application product lifecycle for **clinical and utilization management software** , with a specific focus on driving ... function as a pivotal bridge, translating high-level **clinical and utilization management software** business needs into detailed...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Annapolis, MD)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- BrightSpring Health Services (Baltimore, MD)
- …pharmacy, home health care and primary care, and rehabilitation and behavioral health , we provide comprehensive and more integrated care and clinical ... utilization and hospital admission reduction. + Provides survey management support/ follow-up/and coordination of corrective actions plans relatied to care… more
- Highmark Health (Annapolis, MD)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... decisions, ensuring alignment with the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes and quality of care received, and optimal… more
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